可复性后部脑病综合征的MR诊断  

MRI Diagnosis of Posterior Reversible Encephalopathy Syndrome

作　　者：杜龙庭[1] 王淑媛[1] 陈辉[1] 朱襄明[1] 李军[1] 陈小伟[1] 

机构地区：[1]湖北省襄樊市中心医院放射影像科磁共振室,441021

出　　处：《临床放射学杂志》2009年第11期1573-1575,共3页Journal of Clinical Radiology

摘　　要：目的提高对可复性后部脑病综合征(PRES)的MRI诊断及鉴别诊断的认识。资料与方法回顾性分析8例经临床证实的PRES患者的临床及MRI表现。8例均行MRI检查,其中3例行钆喷替酸葡甲胺(Gd-DTPA)增强扫描,2例行磁共振血管造影(3D-TOF MRA)检查,1例行增强磁共振静脉成像(CE-MRV)检查,6例行扩散加权成像(DWI)。结果MRI显示病灶基本上呈双侧对称性分布,6例位于顶、枕叶皮层及皮层下,2例累及脑干。T1WI呈等或略低信号,T2WI及液体衰减反转恢复(FLAIR)呈高信号,注射Gd-DTPA后无明显异常对比强化,MRA未见明显异常,DWI显示病变扩散受限呈高信号,ADC图呈高信号或为正常。7例经对症处理后多次复查示所有病灶几乎完全吸收消失,临床症状好转;1例因多系统衰竭死亡。结论MRI对PRES的病变范围显示清楚,具有一定的特征性,多种MR检查方法并结合治疗后复查可以明确该病的诊断。Objective To improve the diagnosis of posterior reversible encephalopathy syndrome （PRES）. Materials and Methods MRI and clinical manifestations of 8 patients with PRES confirmed by clinical data were analyzed retrospectively. MRI examination, included sagittal T1WI, axial T1WI, axial T2WI, FLAIR sequences were performed in all the patients. 3 patients underwent contrast MR examination（GD-DTPA）. 3D-TOF MRA, CE-MRV, DWI were underwent in 2, 1 and 6 patients respectively. Results Lesions mainly located in the cortex and subcortical white matter of the parieto and occipital lobes with symmetrical distributions, and the lesions located in the brain stem in 2 cases. MRI showed slightly low or equal signal intensity on Tl WI,high signal intensity on T2 WI and FLAIR. No obvious contrast enhancement was found after intravenous injection of GD-DTPA. MRA showed normal. The lesions showed high signal intensity on DWI and high signal intensity or normal on ADC map. The lesions showed completely absorpted after adequate clinical treatments on fol- low-up MR images in 7 cases with clinical symptom improved. 1 ease died of muhisystem organ failure. Conclusion The MR findings of PRES were typical. The lesions of PRES showed clearly on MRI. and could be diagnosised by multiple MR examine means combined with follow-up after clinical treatment.

关 键 词：可复性后部脑病综合征 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.89[医药卫生—诊断学]